Seanad debates

Thursday, 15 September 2022

Nithe i dtosach suíonna - Commencement Matters

Covid-19 Pandemic

10:30 am

Photo of Martin ConwayMartin Conway (Fine Gael)
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The Minister of State is very welcome to the House. I know she has a very busy day ahead of her.

Covid-19 has dominated our lives for the last two and a half to three years and has cost billions of euro but much more tragically, it has cost lives. While we have had a significant number of fatalities and families grieving as a result of Covid-19, what we also have are lots of people who got Covid-19 and are still suffering from it. I refer to those with what is termed long Covid, whereby people still have symptoms many months, and in some cases more than a year, after contracting the disease. There are people out there who are fatigued, who have lost their sense of taste permanently and who have lost their sense of smell. Some people have had to retire early from work while others are only working short days. There are young people who have been in hospital for lengthy periods as a result of long Covid and who have aged dramatically since they were diagnosed with Covid-19. There are young people out there who were perfectly healthy and fit, who were out running, swimming and doing all of the normal things that young people do who are now fatigued and can hardly move. They are just about able to dress themselves, have lost their sense of smell and taste and many are depressed, in some cases seriously depressed.

Last summer, it was not clear whether the long Covid clinic operated by Dr. Jack Lambert in the Mater Hospital would get the funding needed to continue, which is an unacceptable situation. Just because the pandemic has subsided, Covid is not the health priority it once was and because the country has fully reopened and everything is restored, it does not mean we should forget about the people who have long Covid and are still suffering as a result of it.

There are no figures available on the number of people who are suffering from long Covid. It would be very helpful for us, as policymakers, to have that information. I would also like to know the Government's intentions with regard to long Covid clinics. Are the people who are now running these clinics going to have the certainty of a commitment of funding going forward, in 2023 and beyond? How many long Covid clinics is it proposed to open in other parts of the country? People suffering from long Covid in Cork or Donegal should not have to travel to Dublin to receive treatment. What supports are being provided to GPs in the context of long Covid? Is there a strategy in place of working with GPs so that they can provide the necessary supports to people in their communities who are suffering from long Covid? While I have no doubt there is a strategy and the intention is there, the delivery is what matters. I want to know the figures, the plans in terms of resources and the timelines for delivery of care to support those citizens who are suffering from long Covid.

Photo of Joe O'ReillyJoe O'Reilly (Fine Gael)
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Well done Senator on an excellent exposition within the allocated time.

Photo of Hildegarde NaughtonHildegarde Naughton (Galway West, Fine Gael)
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I thank Senator Conway for raising this really important matter which I am responding to on behalf of the Minister for Health, Deputy Stephen Donnelly. I assure the Senator that services to support those in need of care due to long Covid are being put in place and expanded. Anyone who is concerned about long Covid should engage with their GP in the first instance for advice and referral, where needed.

We know that both Covid and long Covid affect people in a range of different ways with varied symptoms, as Senator Conway has highlighted. As this is still a new disease, information on its features and course is still emerging. The Department of Health and the HSE continue to analyse national and international evidence as it emerges to ensure a comprehensive approach to service development.

The HSE has developed and is implementing an interim model of care to provide long Covid services nationally. This interim model of care builds on existing service provision in addition to establishing new services across a number of healthcare settings. including GP services, community services and acute hospitals, to ensure a comprehensive national service is in place for all those who need to access it. The first priority of the HSE is to ensure there are both long Covid and post-acute Covid clinics operating within each hospital group so that a national service is provided for all who need it.

The Minister for Health is advised by the HSE that the long Covid clinics that have been established as part of the new model of care and are currently operational include those in St. Vincent"s University Hospital, Beaumont Hospital and University Hospital Galway. The post-acute Covid clinics that are operational as part of the new model of care include those at University Hospital Galway and Connolly Hospital Blanchardstown. Both Tallaght University Hospital and St. James's Hospital are operating combined post-acute and long Covid clinics. There is also a tertiary neurocognitive clinic in St. James's Hospital, led by a consultant neurologist with a background in neurocognitive disorders, which is accepting referrals from long Covid clinics around the country. The HSE is working closely with each of the long Covid and post-acute hospital sites to expand the existing clinics to provide a full scope of care. As clinics become fully operational, the HSE will be collating metrics, including waiting lists, numbers of patients treated and numbers of clinics operating. This information will be crucial in ensuring the service meets the needs of patients and it will inform service development.

It is planned that the interim model of care will be expanded to put in place eight post-acute Covid clinics and six long Covid clinics within hospital groups nationwide. Additional aspects of the service are being developed, including supports within the GP and community settings and online supports. The HSE is working with all the sites identified within the model of care to ensure they can become fully operational as soon as possible. As well as these clinics operating within the new model of care, there are clinics operating at HSE sites which were established prior to the model of care being rolled out. It is intended that these clinics would be aligned with the implementation of the model of care.

A sum of €2.2 million has been allocated to the development of long Covid services in 2022 and funding is currently under consideration for next year. The Minister's priority will continue to ensure that all those who are in need of care due to long Covid are able to access a comprehensive national service and get the care they need.

Photo of Martin ConwayMartin Conway (Fine Gael)
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I thank the Minister of State for her response. She has provided a lot more detail than I had heretofore, which is very welcome. However, the sum of €2.2 million equates to less than €50,000 per week and I certainly hope that in the budget of 2023, that figure will be substantially increased. I welcome the fact that we will have six long Covid clinics in the various hospital groups but I am disappointed that the figures have not been collated to date or that we have not been given, at the very least, preliminary figures for the number of people suffering from long Covid. We were one of the best countries in the world in responding to Covid-19 and we must now be one of the best in the world in responding to long Covid. I hope we are gleaning information internationally on how long Covid is being dealt with in other countries, especially those that performed as well as we did during the pandemic. This is a disease that citizens in our country did not have five or ten years ago. As a new phenomenon, it requires a comprehensive response. While we have made a good start, there is much more work to be done.

Photo of Hildegarde NaughtonHildegarde Naughton (Galway West, Fine Gael)
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Again, I thank Senator Conway for raising this very important matter. We all know that long Covid can be a very disruptive and challenging illness. The most common symptoms, as the Senator outlined, are fatigue, weakness, breathlessness, anxiety, difficulties with memory and concentration and musculoskeletal pain.However, more than 50 different signs and symptoms have been identified. I understand that these symptoms can be unpredictable in nature and can fluctuate over time, which can make it challenging for patients and healthcare professionals to understand and manage them.

To ensure patients’ needs are met, a service is being put in place to serve them. We will need to remain agile and responsive, based on learnings from the clinics, from new and emerging evidence and the current and future demand for the service. As part of this learning and evidence-based approach, I am advised that the HSE has recently commissioned the Health Information and Quality Authority, HIQA, to conduct a review of clinical guidelines and of models of care for long Covid. This work is under way and will further inform the development of the service. Further service development will happen this year, including further recruitment to ensure all designated clinics within the model of care are fully staffed. Recruitment to date includes a programme manager and clinical leads representing the fields of respiratory medicine, infectious diseases, neurology, mental health and allied health, and appointments have also been made in community services and general practice. I want to reaffirm the Government’s commitment to ensuring that-----

Photo of Joe O'ReillyJoe O'Reilly (Fine Gael)
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I thank the Minister of State and I thank Senator Conway for raising the issue.